JEFFERSON CITY - With the Jan. 19 deadline looming for Congress to pass a federal spending bill and keep the government running, community health clinics in mid-Missouri and across the country face an uncertain financial future.

Community health centers, like the Family Health Center in Columbia or the Community Health Center of Central Missouri in Jefferson City, are largely funded by federal government grants. According to the National Association of Community Health Centers, centers receive roughly 70 percent of their operating funds from the federal government.

Community health centers provide critical primary care services to more than 27 million Americans each year, many of them in low-income communities or under-served areas, according to the NACHC.

"They serve as a safety net for a lot of individuals in our communities, especially in rural areas where care is scarce," said Matt Younger, vice president of development and external affairs for the Missouri Primary Care Association. "They serve any individual regardless of their ability to pay."

Because of this mandate to serve all customers, regardless of their ability to pay, community health centers rely heavily on federal support. Congress has only allocated enough money to fund the centers through March. Unless Congress achieves a funding fix in its next spending bill, some centers will likely have to reduce services or even close.

The U.S. Department of Health and Human Services estimated that failure to fund health centers in the near-term future could lead to the closure of about 2,800 of the nation's community health centers.

Community health centers employ nearly 160,000 people across the U.S., increasing their economic impact on rural and low-income areas.

Suzanne Alewine of the Missouri Rural Health Association said that community health centers are currently operating under great uncertainty.

"Funding is continuing to be cyclical," Alewine said. "First there's a funding cliff, then there's no funding cliff. Is the government going to shut down on Friday, or is it going to keep running? This ongoing cycle causes a lot of anxiety for care providers."

Alewine said without long-term funding in the next spending bill, health centers cannot provide the level of care needed by many rural communities, which she said have higher rates of diabetes, obesity and other health complications.